In 2007, there were an estimated 1,37-million new cases of TB among people living with HIV and 456 000 deaths. The World Health Organisation (WHO) cautioned that these figures did not reflect an increase in numbers, but an improvement in the quality of the country data, which it said was now more representative and available from more countries than in previous years.

Some African countries showed a sharp increase in HIV testing among people being treated for TB. In 2004, just 4 percent of TB patients in the region were previously tested for HIV. In 2007, that number rose to 37%, with several countries testing more than 75% of TB patients for their HIV status.

The progress report also claimed that because of increased testing for HIV among TB patients, more people are getting appropriate treatment though the numbers still remain a small fraction of those in need. In 2007, 200 000 HIV-positive TB patients were enrolled on co-trimoxazole treatment to prevent opportunistic infections and 100 000 were on antiretroviral therapy.

In Khayelitsha outside Cape Town, 74% of drug-resistant cases diagnosed were also HIV-infected ‘€“ one of the highest co-infection rates in the world.

Delegates meeting this week in Rio de Janeiro for the 3rd Stop TB Partners’€™ Forum are in agreement that TB/HIV co-infection and drug-resistant forms of TB present the greatest challenges, something the progress report highlights.

In 2007 an estimated 500 000 people had multidrug-resistant (MDR) TB, but less than 1% were receiving treatment based on WHO recommendations.

The WHO estimates that there are more than 14 000 MDR TB cases arising in South Africa each year, but these figures are likely to be dated as they are derived from the last national survey conducted in 2000-2001 and are likely to be an underestimate. Even so, the estimated incidence of MDR TV is among the highest in the world.

In Cape Town over a thousand people marched on the provincial government yesterday demanding improved treatment services for people living with TB and HIV. Activists demanded that the national health department increase its efforts to decrease the burden of TB in people living with HIV through adoption and implementation of interventions promoted by the WHO, called the 3 I ´s ‘€“ intensified TB case finding, infection control and isoniazid preventative therapy (IPT).

IPT consists of taking one pill, an antibiotic isoniazid daily for between 6 and 9 months to prevent the development of active TB. IPT has proven to be safe and effective at reducing the risk of active TB in people living with HIV.

The report also raises concern over an increasing shortage in funding. Ninety-four countries in which 93% of the world’€™s TB cases occur provided complete financial data for the report. To meet the 2009 milestones in the Stop TB Partnership’€™s Global Plan to Stop TB, the funding shortfall for these 94 countries has risen to U$1,5-billion.

Full funding of the plan will achieve its aim of halving TB prevalence and deaths (compared with 1990 levels) by 2015.

Latest figures released at the Rio meeting estimate that 9,27-million people were living with TB in 2007 while almost 2-million died. Over 500 000 people were diagnosed with MDR TB and 50 000 with XDR TB in 2007.